Jerryd Richards
Flagler Beach,FL
Summary
Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.
Overview
8
8
years of professional experience
4
4
years of post-secondary education
3
3
Certifications
Work History
Authorization Specialist II
Centene
12.2023 - Current
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Prevented delays in care delivery by proactively identifying potential issues during pre-authorization process and seeking clarification from providers when needed.
- Supported clinical staff by providing timely updates on status of prior authorizations for various services.
- Reduced processing times by effectively managing high volume of authorizations, referrals, and appeals.
- Facilitated smooth transitions between different levels of care by coordinating required authorizations for patients moving from one service setting to another.
- Attended ongoing professional training to facilitate accurate and productive credit management.
- Established databases to track, analyze and automate eligibility application processes.
- Promoted positive customer experiences by addressing concerns or questions related to authorizations by utilizing professional tactics.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
- Evaluated trends in authorization denials to identify areas for improvement in both internal processes and external communications with payers.
Referral Specialist I
Centene Corporation
8 2021 - 12.2023
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Professional liaison between referring physicians and specialists, establishing trust and rapport through professionalism.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Provided ongoing training for new Referral Specialist staff members, ensuring consistent quality service delivery across teams.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Supported healthcare team members by providing detailed patient information for seamless transitions between providers.
- Obtained prior authorization for outpatient and inpatient procedures.
- Promoted clear communication between primary care providers and specialists through detailed documentation and follow-up calls.
- Processed referral requests from patients, doctors, and other health care professionals.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
Project Coordinator
Durables Unlimited LLC
09.2018 - 08.2021
- Solved complex problems to increase sales effectiveness and streamline business direction
- Successfully managed multiple projects simultaneously by prioritizing tasks according to urgency, resource availability, and alignment with organizational goals.
- Planned, designed, and scheduled phases for projects.
- Established effective communication among team members for enhanced collaboration and successful project completion.
- Developed and initiated projects, managed costs, and monitored performance.
- Prepared and submitted project invoices for review and approval.
- Negotiated and managed third-party contracts related to project deliverables.
- Developed and implemented project plans and budgets to ensure successful execution.
- Scheduled and facilitated meetings between project stakeholders to discuss deliverables, schedules and conflicts.
- Boosted revenue opportunities by initiating strategic sales strategies based on industry trend and competitive analysis
- Established contracts with 10+ vendors, securing wholesale produce and equipment 20-60% below market value
- Researched markets and key audiences to increase profits through effective marketing and branding strategies
- Exceeded sales goals through effective time management and resource allocations
- Cultivated domestic and international consumer base
- Significantly increased unit sales by 795% from Jan 2019- Dec 2020 by doubling client base in under 2 years.
- Power Seller recognition through seller platform
- 1000+ Positive Feedback on third party seller platforms in less than 12 months
Patient Financial Representative
Baptist Health South Florida
03.2016 - 08.2018
- Implemented effective time management strategies, consistently meeting deadlines for claim submission and follow-up activities.
- Facilitated smooth registration processes for emergency room patients, ensuring accurate data collection and quick access to care.
- Accurately reviewed and updated patient and financial information.
- Improved patient satisfaction by providing accurate and timely billing information.
- Answered customer insurance and payment questions related to copayment and coinsurance concerns.
- Interviewed patients about payment plans, and provided applications for payment assistance.
- Professional liaison between patients, providers, and insurance companies, facilitating communication around financial matters.
- Prevented impending loss and increased profitability by enforcing scheduled collection campaigns, consistently achieving targeted recovery rate.
- Supported hospital''s mission to provide quality healthcare by accurately calculating patients'' financial responsibilities using established guidelines.
- Resolved complex insurance and customer payment issues by providing options or escalating problems to supervisors.
- Analyzed customer financial records to determine appropriate payment plan.
Education
Bachelor of Science - Business Administration
Pace University
Pleasantville, NY 08.2008 - 05.2012
Skills
Excel
Data Analysis
Leadership
Project Management
SQL
Smartsheet
Microsoft Office
Data Cleaning
Trend Analysis
SharePoint
Certification
Foundations: Data, Data, Everywhere
Accomplishments
- Supervised team of 8 staff members for new hire job training.
- Resolved durable medical equipment product issues through consumer testing.
- Documented and resolved shipment logistic issues which led to 80% increase in sales..
Timeline
Authorization Specialist II
Centene
12.2023 - Current
Prepare Data for Exploration
08-2022
Foundations: Data, Data, Everywhere
07-2022
Ask Questions to Make Data-Driven Decisions
07-2022
Project Coordinator
Durables Unlimited LLC
09.2018 - 08.2021
Patient Financial Representative
Baptist Health South Florida
03.2016 - 08.2018
Bachelor of Science - Business Administration
Pace University
08.2008 - 05.2012
Referral Specialist I
Centene Corporation
8 2021 - 12.2023